Background: membranous glomerulopathy (MG) is an immunomediated disorder which accounts for the most
common cause of nephrotic syndrome (NS) following allogeneic hematopoietic stem cell transplantation (HSCT).
Objective and Methods: to provide an update on the issue by reviewing pertinent literature on the MEDLINE database.
Results: sixty-nine post allogenic HSCT patients (42 male) with MG were identified. The median age was 43 (5 to 68)
years. Time interval from allogenic HSCT to MG diagnosis ranged from 3 to 134 months (median 17). Most MG patients
had a history of acute (70%) or chronic (84%) graft versus host disease (GVHD). Corticosteroids and cyclosporine were
the most common therapeutic agents used in this setting; alternative therapies, including rituximab, were given to a lower
number of patients. Outcome data were available in 64 out of 69 MG patients; 38 (59%) and 18 (28%) patients achieved a
complete and a partial response respectively, whereas treatment failure was recorded in the remaining 8 (13%).
Conclusion: MG after allogenic HSCT appears to be associated with a sub clinical or overt cGVHD, which follows the
discontinuation of immunosuppressive prophylaxis. Although a standard therapeutic approach has not been established,
the application of available measures can induce favorable response in more than 80% of affected patients, but treatmentfailure
and progressive deterioration of the renal function may occur in about one fifth of cases.
Keywords: Allogeneic hematopoietic stem cell transplantation, chemotherapy, conditioning regimen, corticostroids,
cyclosporine, glomerulonephritis, graft-versus-host disease, leukemia, lymphoma, membranous glomerulopathy, multiple
myeloma, nephrotic syndrome, radiotherapy, renal failure, rituximab
Rights & PermissionsPrintExport